- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12.63 / $21.41 / $74.05
| Facility | | $12.63 | $21.41 | $74.05 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.39 / $12.63 / $19.89
| Professional | | $10.39 | $12.63 | $19.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.11 / $26.88 / $100.00
| Facility | | $14.11 | $26.88 | $100.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.64 / $12.10 / $25.54
| Professional | | $6.64 | $12.10 | $25.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9.30 / $24.36 / $39.33
| Facility | | $9.30 | $24.36 | $39.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.30 / $17.86 / $26.78
| Professional | | $9.30 | $17.86 | $26.78 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $9.56 / $12.97 / $14.26
| Professional | | $9.56 | $12.97 | $14.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.44 / $14.11 / $34.85
| Facility | | $13.44 | $14.11 | $34.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13.44 / $20.16 / $36.96
| Facility | | $13.44 | $20.16 | $36.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $12.10 / $12.10 / $12.10
| Professional | | $12.10 | $12.10 | $12.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14.47 / $22.06 / $36.96
| Facility | | $14.47 | $22.06 | $36.96 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $10.08 / $13.44 / $35.93
| Professional | | $10.08 | $13.44 | $35.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $5.64 / $5.64 / $14.70
| Professional | | $5.64 | $5.64 | $14.70 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $6.05 / $6.05 / $6.96
| Professional | | $6.05 | $6.05 | $6.96 |